© 1996 American Heart Association, Inc.
Articles |
Blood Velocity Profiles in the Human Renal Artery by Doppler Ultrasound and Their Relationship to Atherosclerosis
From the Departments of Medical Engineering, Systems Cardiology, and Urology, Kawasaki Medical School, Kurashiki, Okayama, Japan (T.Y., Y.O., A.K., H.T., O.H., K.T., F.K.); the Centre for Biological and Medical Systems, Imperial College, London, UK (M.J.L., K.H.P., C.G.C.); and the Princess of Wales Hospital, Bridgend, UK (C.J.H.J.).
Correspondence to Tokunori Yamamoto, MD, Departments of Medical Engineering and Urology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-01, Japan.
Abstract Blood velocity profiles were measured in the renal branch (diameter 5.9±1.3 mm) of the aortorenal bifurcation using a 20-MHz 80-channel pulsed Doppler velocimeter during retroperitoneal surgery in 10 patients. The peak Reynolds number was 1145±140 and the frequency parameter (Wormersley parameter) was 3.0±0.8. Immediately distal to the ostium of the renal artery, reverse flow, indicating flow separation, was observed near the cranial wall mainly during the first part of the cardiac cycle. There were flows from the cranial to the caudal side of the artery at this location, indicating the presence of strong secondary flows. Two diameters downstream of the ostium, the velocity profiles were skewed to the caudal side in all patients. Four diameters downstream, the flow profile was symmetrical (3 patients) or only slightly skewed (7 patients) and virtually parabolic throughout the cardiac cycle. These observations mean that the flow on the cranial side of the renal branch of the human aortorenal bifurcation is characterized by (1) a bidirectional oscillation of the flow, (2) separation of the flow during systole, and (3) low time-averaged shear rate. These blood velocity patterns may be related to the localization and development of atheromatous plaque that occurs preferentially in this region of the renal artery. Conversely, the unidirectional, axisymmetrical flow found in more distal parts of the renal artery are associated with a very low incidence of lesions.
Key Words: atherogenesis • aortorenal bifurcation • low time-averaged shear rate • flow separation • flow oscillation
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